This manual reviews practical procedures in the assessment of renal fluoride excretion based on experience from existing national fluoridation programs. The assessment tools will primarily be useful in assisting countries in achieving an effective fluoride exposure. It is a hope that the manual will stimulate oral health personnel and public health administrators to use a systematic approach for managing and analyzing data obtained from different levels of fluoride exposure. Finally, the manual encourages inter-country collaboration on surveillance systems for community programs using fluoride for prevention of dental caries.